Skin and systematic disease Flashcards
Name 3 genetic GI diseases that show skin changes
Hereditary haemorrhagic telangiectasia
Ehlers danlos (collagen – genetic)
Blue rubber bleb naevus - blue marks on the skin and internal organs caused by abnormal veins
Name 3 Inflammatory/autoimmune GI diseases that show skin changes
Erythema nodosum
Degas disease – GI haemorrhage - develop papules
Pyoderma gangrenosum - common in IBD - pustules or nodules become ulcers that progressively grow
Vitamin A can result in what?
Papule formation
Which vitamins are deficient in Scurvy or Beriberi?
Scurvy = vitamin c Beriberi = vitamin b1 (thiamine)
Skin signs in Diabetes (6)
Acanthosis nigricans - brown to black, velvety hyperpigmentation
Diabetic bullae
Diabetic dermopathy
Disseminated granuloma annulare - ring or arc-shaped areas on the skin.
Eruptive xanthomas - pink papules with creamy centre
Necrobiosis lipoidica - rare granulomatous skin disorder which can affect the shin
Skin changes in thyroid disorders
Hyperthyroidism - Thyroid acropachy - soft-tissue swelling of the hands and clubbing of the fingers.
Hypothyroidism - pre-tibial myxoedema
Autoimmune diseases that have associated skin changes
Cutaneous lupus
Cutaneous vasculitis (small vessel = commonest)
Alopecia
Vitiligo
Presentation of Cutaneous lupus
Cutaneous – Butterfly rash/Plaques with clear margins/Photosensitivity /Negative antibodies
Alopecia
Alopecia areata - body rejects own hair (T-lymphocyte, cytokine rejection of hair). Totalis = loss on scalp, universalis = all over the body
Cause of Vitiligo
Destruction of melanocytes
In Cancer, the common underlying malignancies causing skin changes are…
Carcinoid Syndrome Ectopic ACTH Pagets disease Paraneoplastic pemphigus Acquired hypertrichosis Erythema Gyratum Repens Bazex Syndrome Leser Trelat
What is Carcinoid syndrome? How does it present?
A paraneoplastic syndrome i.e it is the direct result of a tumour.
Episodic flushing (mins-hours), no sweating. Facial telangiectasia due to continual blushing
GI carcinoid arises due to metastases from which organ?
Liver
What is Ectopic ACTH syndrome caused by? What skin changes are seen in this condition?
Tumour production of adrenocorticotropic hormone (ACTH)
Generalised Hyperpigmentation
Causes increased MSH so increased release of melanin from melanocytes
Skin changes associated with Paget’s disease
Eczematous Plaque (nipple/Areola) which is an extension of underlying ductal adenocarcinoma
Extra-Mammary Pagets
Looks similar to eczema
Usually in axilla or an-genital areas
As a result of Primary Intraepithelial
Adenocarcinoma in ¾ cases
Paraneoplastic Pemphigus
Erosive stomatitis (mouth), rash
Associated with underlying malignancy
Auto-antibodies driven - attack proteins holding skin together (blister formation)
Associated with non-hodgkin’s + castlemans disease
Acquired hypertrichosis lanuginosa
Very rare
Acute onset of lanugo (thin, unpigmented) hairs on face and body
linked with colorectal cancer or lung cancer
Erythema Gyratum Repens
Concentric erythematous lesions
Associated with lung cancer
Bazex Syndrome
Symmetrical hyperkeratosis of hands and feet
Associated with SCC: Bronchial, oropharyngeal, Gastric, colon, biliary adenocarcinomas
Leser - trelat
Eruptive seborrhoeic keratosis
GI adenocarcinomas
Skin conditions associated with cancer
Acanthosis Nigricans
Dermatomyositis
Acquired angioedema
Dermatomyositis
Inflammatory myopathy + rash
Rash around the eyes
Gottrons papules: red maculo-papular lesions over bony prominences
Shawl sign - rash over where you’d wear a shawl
Photosensitive
Asso with -Ovarian, breast, lung ca
Skin conditions that may be associated with malignancy
Bullous pemphgoid - common
Sweets Syndrome - rare
Pyoderma gangrenosum
Acquired ichthyosis
